Quantitative and qualitative verification of data quality in the childbirth registers of two rural district hospitals in Western Kenya

Abstract

Objectiveto verify the data quality of childbirth registers and explore factors that influence quality at two rural district hospitals in Western Kenya. Designa retrospective comparative case study for data quality of the 2006 childbirth registers by quantitative and qualitative methods. SettingSiaya and Bondo District Hospitals. Methodsafter confirming the physical condition and availability of childbirth registers, the total number of births; number of complete/incomplete data; and number of complete data that were illegible, incorrectly coded, inappropriate and unrecognised were verified quantitatively to evaluate accuracy and completeness. Data categories and instructions were examined qualitatively to assess the relevance, completeness and accuracy of the data. Semi-structured interviews were conducted with key informants to capture their views and factors that influence data quality. Findingsthe childbirth registers used by the two hospitals were not developed by the Ministry of Health, and their supply to Bondo was interrupted. Of the 30 data categories in the registers, five for Siaya and 23 for Bondo were more than 20% incomplete. Data for number of antenatal consultations and use of human immunodeficiency virus drugs were at least 50% incomplete for both hospitals. The percentage of illegible, incorrectly coded and inappropriate data was relatively low, and only the place of residence had unrecognised data. Data categories in the registers did not correspond well with those of monthly reports, and inappropriate instructions suggested hidden inaccuracy among apparently valid data. Organisational impediments of the health information system in general, perinatal and intrapartum contexts were identified. Key conclusionsdata quality of the childbirth registers was unsatisfactory. Influential factors were primarily organisational and technical, which may have had an adverse effect on midwives' record keeping behaviour. Implications for practicedata quality of the registers can be improved by re-examining technical challenges and organisational impediments at different levels. Midwives' awareness of data quality needs to be increased by sharing the purpose of the childbirth registers. Strong political commitment is also indispensable for putting these findings into action.